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PubMed2006

Characteristics of telephone calls in a psychiatric outpatient practice.

OBJECTIVE: The goal of this study was to document the volume and characteristics of telephone calls from patients in an outpatient psychiatric clinic. METHODS: Telephone calls from a psychiatric resident's patients were logged over a 6-month period. Information collected included sex of the caller, reason for the call, deemed importance of the call, primary psychiatric diagnosis, and insurance type. RESULTS: A total of 291 calls occurred during the 6-month period, with an average of 2.4 calls per work day. The physician deemed 1.5% of calls to be an emergency and 15% to be urgent. Of the resident's total case load of 115 patients over the 6 month period, 29% (n = 33) of patients never made physician-patient telephone contact. Female patients were significantly more likely to call than males. Requests for medication refills were the most frequent type of call (38%). The mean number of calls per patient in the caseload was significantly different across diagnostic groups, with patients with personality disorders and anxiety spectrum disorders making more calls than other groups. There was no significant difference in the volume of telephone calls between patients with private health insurance and those without. CONCLUSION: This study may be of particular interest to physicians and managed care systems who are interested in reimbursement for telephone psychiatry. This study confirms and extends the previously reported association between certain psychiatric disorders (personality disorders, anxiety spectrum disorders) and relative frequency of telephone calls to the physician. In addition, the high volume of calls for prescription refills is an important issue in telephone management.

Emergencies↗
PubMedDate not supplied

[Psychiatry--where are we and where are we going?].

The article gives a short review of the historical, ideological, theoretical and organizational development of the concept of protection and improvement of mental health (within a psychiatric context) both in Croatia and the rest of the world with special emphasis on the problems and possibilities which arise from the present situation in Croatia. It also explains the necessity to analyze the Law on Health Care and Health Insurance from a psychiatric point of view, the need to link the areas of psychiatry (preventive and clinical work) which deal with primary protection, the need to define the criteria and standards regarding the organization and reorganization of psychiatric clinics and general hospitals, the need to analyze and reorganize the study of psychiatry, the need to establish national and regional coordination boards and hold elections for national and regional coordinators and the need to establish the Centre for the Protected and Improvement of Mental Health.

Croatia↗
PubMed1980

The Mental and Nervous Disorder Utilization and Cost Survey: an analysis of insurance for mental disorders.

The Mental and Nervous Disorder Utilization and Cost Survey in Washington, D.C., has yielded useful information about outpatient utilization within an insurance plan with broad mental health coverage, as well as evidence that a comprehensive benefit with a low deductible and copayment can be offered and reasonably utilized. From the results of this survey and a substudy of claims made during 1977, the authors conclude that psychiatric diagnostic information submitted on insurance claim forms may often be inaccurate, primarily because of providers' concerns about confidentiality; such information is of little use for peer review or claims review. The authors state that caution must be exercised in generalizing from the experience under this plan to speculate about outpatient utilization which might result from broad coverage on a national level.

Ambulatory Care↗
PubMed1993

[The socioeconomic problems of a mental health service].

The state and prospects of the development of mental health service are discussed. Special attention is drawn to the economic aspects of mental health service and financial problems, in particular. The principles of creation and utilization of financial resources for psychiatric facilities in conditions of medical insurance are given. Social and economic aspects of mental diseases and their cost for the society are considered. The conclusion is made on the priority of psychiatric care programmes among other programmes of health care, that must be solved on the state level.

Delivery of Health Care↗
PubMed2006

Estimated payments to employment service providers for persons with mental illness in the Ticket to Work program.

OBJECTIVE: The Ticket to Work and Work Incentives Improvement Act of 1999 removes work disincentives and promotes access to vocational services for people with disabilities. This study calculated the amount of payments that would have been made to employment service providers if study participants had been enrolled in the Ticket program. METHODS: Data were from 450 Social Security Disability Insurance beneficiaries with psychiatric disabilities enrolled in a multisite study of supported employment. Earnings over two years were used to calculate provider payments under two reimbursement formulas used in the Ticket program. RESULTS: Only a quarter of service recipients (26 percent) reached earnings levels that would have triggered provider payments under the first reimbursement formula. Only 4 percent would have completed their trial work period and left the rolls, generating payments under the second formula. CONCLUSIONS: The current provider payment systems of the Ticket to Work program do not reflect the reality of rehabilitation for individuals with severe mental illness. Reforms should take into account outcomes of return-to-work services for this population.

Adolescent↗
PubMed1993

Clozapine: an appraisal of its pharmacoeconomic benefits in the treatment of schizophrenia.

Clozapine, an antipsychotic agent with relatively weak central antidopaminergic activity, displays atypical pharmacological and clinical properties vis-a-vis the classic antipsychotics. Thus, clozapine is effective against both the positive and negative symptoms of schizophrenia and has a low propensity to cause extrapyramidal effects. Furthermore, clozapine is effective in a substantial proportion (up to 60%) of patients who are refractory to or intolerant of standard antipsychotic therapy. Despite its promising therapeutic potential, the relatively high incidence of clozapine-induced agranulocytosis (approximately 1% of patients) and the associated need for regular haematological monitoring currently restricts the drug's use to the treatment of chronic and severe schizophrenia refractory to standard antipsychotic therapy, and to those patients unable to tolerate such therapy. In the US, the current wholesale price of clozapine (exclusive of monitoring) is $US2.85 per 100mg tablet, amounting to $US4160 annually (1992 dollars) at the most commonly prescribed dose of 400 mg/day ($US2.40 per tablet and $US3510 annually to state programmes through Medicaid reimbursement legislation). In the UK, the annual cost of clozapine (at the average dose of 300 mg/day), inclusive of blood monitoring, is 1806 British pounds sterling (1992 pounds). Although the acquisition cost of clozapine is high in comparison with that of standard antipsychotics, preliminary cost-effectiveness estimates in patients with treatment-resistant schizophrenia suggest that the clinical benefits of the drug (viz. improved psychopathology, social functioning and quality of life) may confer medium to long term economic benefits, primarily by reducing the need for psychiatric hospital services. This effect is most likely to be seen on long term ( greater than or equal to 2 years) maintenance therapy with clozapine. Savings in hospital costs are, however, likely to be offset, at least initially, by increased reliance on outpatient services, and clozapine may therefore confer additional economic costs during the first year or so of treatment. In the longer term, however, the initial cost investment may be recouped in the form of savings to psychiatric institutions and insurers.

Clozapine↗
PubMedDate not supplied

Reports uncover disreputable charges of fraud in records.

Recent articles in the media have disclosed charges of unethical practices related to tampering with patient medical and administrative management records to enhance the institution's stature in the eyes of accrediting and quality assurance bodies, and of questionable practices regarding referrals and insurance abuse at psychiatric facilities. The following articles and regulations that have emerged summarize some of these specific charges and efforts to stem these practices.

Accreditation↗
PubMed1985

Psychiatric Malpractice: The Electroconvulsive Therapy Experience.

The malpractice experience of the American Psychiatric Association professional insurance program from 1972 to 1983 is reviewed. Seventeen cases among 711 "closed" cases related to electroconvulsive therapy (ECT). Nine were settled in favor of the psychiatrist; one case was tried and the jury found for the psychiatrist. Patients prevailed in seven cases by settlement. The author concludes that malpractice losses are not a significant factor in ECT practice or in its negative public image.

Journal Article↗
PubMed1986

Trends in private insurance coverage for mental illness.

The authors analyzed data from the U.S. Bureau of Labor Statistics Level of Benefits Surveys for the period 1979-1984 to examine coverage for psychiatric disorders in the private sector. While the overall number of employees with psychiatric benefits has increased, a greater percentage have more restrictions on those benefits. The extent of coverage is wide ranging, but there is little depth and the majority of psychiatric care expenses are not insured. Although the figures do not suggest a dramatic cutback in insurance coverage, the trends toward increased reductions in benefits for all health care threaten the more vulnerable psychiatric benefits.

Alcoholism↗
PubMed1978

Considerations in the design of mental health benefits under National Health Insurance.

The existing insurance coverage for mental health benefits provides incentives for hospital as compared with community care and reinforces a medical approach to psychological disability. Moreover, the structure of benefits favors the affluent as compared with the disadvantaged and provides little assistance for the community integration of the chronic mental patient. In considering mental health benefits under National Health Insurance we must be careful to avoid reinforcing these patterns. It is suggested that NHI include a mental health resource development fund intended for building a stronger network of community mental health care and that the pattern of insurance benefits under NHI be consistent with developing psychiatric services on a capitation basis.

Community Mental Health Services↗